Bariatric surgery is one of the most effective way to lose weight,which suppresses appetite through the central nervous system. The mechanisms of appetite change may include gut hormones, adipokines, as well as microbiota in the intestine.

Objective To explore the clinical effect of periarticular knee fractures combined with anterolateral ligament (ALL) avulsion fracture.Methods From June 2014 to November 2015,13 patients with ALL avulsion fracture in periarticular knee fractures were fixed by the star plate,cannulated or screws suture anchor,including 9 male and 3 female with the mean age of 39.5 years (range from 28 to 51 years).6 patients were diagnosed distal femoral fracture,4 tibial plateau fracture,and 3 tibial intercondylar eminence avulsion fracture which all combined with ALL avulsion fracture.Postoperatively,all patients were treated with the adjustable knee brace for 3 months.Results All patients were followed up for 4-20 months,the mean follow-up time was 13.5 months.The average surgical time was 130 min (range from 90 to 210 min).In all 13 patients,ALL was found and identified.Bone union was obtained in all patients,and the bone union time was 11.4 weeks (10-12 weeks).7 cases were fixed with star plate,5 cases were fixed with hollow screw,and 1 case was fixed with anchor.All follow-up patients underwent anteroposterior and lateral X-rays.Pain,swelling and functional recovery of the knee joint were observed.Patients were assessed postoperatively with International Knee Documentation Committee (IKDC) score,Lysholm score,and Tegner activity scale to evaluate the clinical effect.At the last follow-up,all patients had full range of motion of the knee joint which from 0° to approximate 120°.The Lysholm,objective IKDC were 86.5 and 84.6 respectively.Among the 13 patients evaluated,9 patients were graded A,and 4 patients were graded B by subjective IKDC.The Tegner activity scale at the last follow-up was 6.7.Incision of poor healing in 1 case,and got healed after 32 d cleaning dressing.Conclusion This study confirmed the presence of the ALL.The fixation of ALL avulsion fracture in periarticular knee fractures can be an effective procedure at a minimum follow-up of 13.5 months.

Objective To analyze the causes of blood deficiency in the process of voluntary blood donation and to adopt targeted control measures,so as to effectively reduce blood scrapping and to better ensure theclinical blood use of the hospital.Methods The data of blood collection from January 2014 to December 2016 and the various reasons of insufficient blood collection were summarized;and according to these data as the object of study,the targeted measures were taken to observe the effect.Results According to the the reasons for the lack of blood collection,the targeted measures,such as organizing staff training,strengthening communication with blood donors and so on,were taken.After the implementation of these measures,the phenomenon of insufficient blood collection from 2014 to 2016 showed declining trend,withthe proportion decreased from 0.29％ to 0.20％.Conclusion To strengthen the staff staining in order to improve them vein collection technology,to publicize further,to communicate with blood donors effectively and improve the blood donation services,to ease the feelings of blood donors and to create a warm,harmonious and orderly blood donation atmosphere;all of these should be helpful for reducing the occurrence of insufficient blood collection.

Objective To summarize MRI findings of focal cortical dysplasia (FCD), analyze MRI characteristics of various pathological subtypes of focal cortical dysplasia. Methods Forty-four patients with FCD were collected. Their MRI findings were analyzed retrospectively. According to pathologic findings, these patients were divided into FCD type Ⅰ group and FCD type Ⅱ group. The following MR signs were observed in the two types of FCD: ( 1 ) Focal thickening of the cortex. ( 2 ) Blurring of the gray matter-white matter junction. ( 3 ) Tapering of white matter signal intensity alteration toward the ventricle on FLAIR and on T2WI. (4)Focal brain hypoplasia. (5)Increased signal intensity of gray matter on FLAIR. (6)Increased signal intensity of gray matter on T2 WI. ( 7 ) Increased signal intensity of subcortical white matter on FLAIR.(8) Increased signal intensity of subeortical white matter on T2WI. (9) Decreased signal intensity of subcortical white matter on T1 WI. The χ2 tests and corrected χ2 tests were used for comparison between the two groups. Results In the 44 cases, there were 30 cases with FCD type Ⅰ and 14 cases with FCD type Ⅱ. FCD was identified by MRI in 32 cases. Blurring of the gray-white matter junction is the most common sign of FCD (23 cases). There were 21 cases identified by MRI in FCD type Ⅰ group. Focal brain hypoplasia is a typical sign of FCD type Ⅰ , which was found in 11 cases in FCD type Ⅰ group but none in FCD type Ⅱ group. There was statistically significant difference between the two groups (continuity corrected χ2 =5. 0286,P =0. 0249) . In FCD type Ⅱ group, 11 cases were identified by MRI. Increased cortical thickness was found in 10 eases in FCD type Ⅱ group and 11 cases in FCD type Ⅰ group ( χ2 =4. 6234 ,P =0. 0315). Increased signal intensity of subcortical white matter on FLAIR was found in 9 cases in FCD type Ⅱ group and 7 cases in FCD type Ⅰ group (χ2 =6.9180,P =0.0085). Tapering of white matter signal intensity alteration toward the ventricle was found in 4 cases in FCD type Ⅱ group and none in FCD type Ⅰ group ( continuity corrected χ2 = 6. 2883, P = 0. 0122). The above-mentioned three MRI findings showed statistically significant difference between the two groups and were features of FCD type Ⅱ.All of the other MRI findings showed no statistically significant difference between the two groups. Conclusions Different pathological subtypes of FCD have different MRI characteristics. It is helpful to make preoperative diagnosis and planning.

Objective To assess the diagnostic value of magnetic source imaging(MSI) in the preoperative localization of focal cortical dysplasia(FCD). Methods Eighty-two patients with intractable epilepsy resulting from FCD undergone preoperative assessment including MSI, video electroencephalography(VEEG) and electrocorticography(ECoG)from February 2006 to June 2012.The consistency between pre- and intra-surgical assessment was evaluated. For patients who had consistent results,postoperative curative effect was also recorded. The accuracy and predictive values of noninvasive preoperative tests were compared by χ2 test. Results For MSI and ECoG, their results were consistent in 57 cases, partially consistent in 14 cases, and inconsistent in 11 cases. In the postoperative follow-up of 57 patients with consistent results, there were 46 cases with Engel class Ⅰ, 3 cases with Engel class Ⅱ, 4 cases with Engel class Ⅲ, and 4 cases with Engel class IV. For VEEG and ECoG, the results were consistent in 43 cases, partially consistent in 33 cases, inconsistent in 6 cases.The postoperative follow-up showed that 27 cases were graded as Engel classⅠ, 5 cases as Engel classⅡ,7 cases as Engel classⅢ, and 4 cases as Engel class IV. There were statistically significant differences(χ2=5.023,P=0.025)of the concordance rate with ECoG between MSI(69.51%,57/82)and VEEG(52.44%,43/82). In the postoperative follow-up of patients with consistent results, the curative effect was better in group MSI than in group VEEG (χ2=3.989,P=0.046). Conclusions Preoperativelocalization by MSI shows advantage over VEEG, which meanswhen it achieves an agreement with ECoG, patients with FCD may get better prognosis from the surgical process.

The genes of short armed hammerhead ribozyme targeting against two sites on positive strand (194-196) and negative strand (89-91) of ASSVd were designed, synthesized and cloned according to the action manner of hammerhead ribozyme. The full lengths of the genes are 42 bp (RzASSVd(+)) and 40 bp (RzASSVd(-)). After transcription in vitro, the ASSVd positive and negative RNA labeled with 32P were mixed with the ribozyme transcript and incubated 3-4 h at 50 degrees C or 37 degrees C. The results were assayed on 8% PAGE (containing 8 mol/L urea) and autoradiogrammed. As predicted, the transcript of the active RzASSVd(-) could cleave the ASSVd negative strand RNA with a high activity but had no cleavage effect on the ASSVd positive strand. The transcript of the RzASSVd(+) gene could cleave the ASSVd positive strand but its cleavage activity was very low. As the same, it cannot cleave the negative strand either. On the base of the result, we construct dimmer ribozyme gene pGEMRzASSVd(+/-) containing both RzASSVd(+) and RzASSVd(-).
Cloning, Molecular ; Malus ; virology ; Plant Diseases ; virology ; RNA, Catalytic ; genetics ; metabolism ; therapeutic use ; RNA, Viral ; metabolism ; Substrate Specificity ; Transcription, Genetic ; Viroids ; metabolism

Objective: To investigate the clinical features of patients with hyperextension bicondylar tibial plateau fractures (HEBTPs), and assess surgical effectiveness of HEBTP and non-HEBTP fracture patients. Methods: From June 2014 to May 2017, 82 patients with bicondylar tibial plateau fracture were included in this study. There were 63 patients with 63 knees (76.8%) that had sustained non-HEBTPs, and 19 patients with 19 knees (23.2%) that had HEBTPs, including 49 males and 33 females with a mean age of 48.3 years (range, 22-76). Of the 19 HEBTPs patients, 4 cases were hyperextension valgus injury, 9 cases were hyperextension varus injury, and 6 cases were pure hyperextension injury. All patients were treated with open reduction internal fixation combined with bone grafting or non-bone grafting. All follow-up patients were evaluated clinically and radiographically, included the incidence of associated injuries, infection, posttraumatic osteoarthritis, range of motion (ROM) of knee, numeric rating scale (NRS) for assessment of pain, and Short Musculoskeletal Functional Assessment (SMFA) scores for assessment of knee function. The fracture healing and postoperative alignment were assessed with anteroposterior and lateral X-rays. Results: All patients were followed up for 12-22 months, the mean follow-up time was 15.4 months. Bone union was obtained in all patients, and the bone union time was 12.6 weeks (ranged: 12-16 weeks). At the last follow up, all patients had full range of motion. The incidence of significant associated injuries was 36.8% in the HEVBTP group compared with 15.8% in the non-HEBTP group. The incidence of popliteal artery injury, common peroneal nerve injury and ligament injury that needed repair in 19 HEBTPs patients was 21.1%, 26.3% and 31.6%, respectively, while the corresponding incidence of complications in 63 non-HEBTPs patients was 3.2%, 4.8%, and 9.5%, respectively. The NRS pain score of HEBTPs and non-HEBTPs at 12 months after surgery was 3.89±1.9 and 2.76±1.88, respectively. The value of HEBTPs patients was higher than that of non-HEBTPs patients, But the difference was not statistically significant. The SMFA scores of HEBTPs and non-HEBTPs patients at 12 months after surgery were 27.27±19.44 and 17.09±15.87, respectively. Patients with HEBTP had higher functional (SMFA) scores and a trend of higher pain scores than those with non-HEBTP, indicating associated soft-tissue damage and developed posttraumatic osteoarthritis. Conclusion The present showed that the HEBTP is a unique fracture. These injuries result in worse functional outcomes than non-HEBTP. Physicians must recognize the possible associated injuries (included ligaments, vessels and nerves), and the treatment effect of HEBTP is relatively poor.

To assay the influence of dendritic cells(DCs)on the function of anti-infective immunity to Penicillium marneffei.DCs were generated from peripheral blood mononuclear cells(PBMC)and pulsed with Penicillium marneffei yeasts.DCs morphology was observed by the inverted microscope and cell surface markers of DCs were analyzed by flow cytometry.The concentrations of IL-12p70 were detected by ELISA. Mixed lymphocyte reaction was performed to assay the proliferation of T cells.The mRNA of CCR7 and CXCR4 were detected by the Real-time PCR quantifications.The acquired DCs exhibited irregular appearance and numerous long dendrites under light microscope.DCs and Penicillium marneffei yeasts were co-cultured for 24 h,numerous yeasts were observed inside the cells;an enhanced expression of the cell sur-face markers CD86、CD83、HLA-DR and CD40 were demonstrated;the expression of CCR7 and CXCR4 mRNA were also increased;the improved proliferation of T cells were observed in the mixed lymphocyte reaction.Yeasts-pulsed DCs secreted more IL-12p70 than that of non-pulsed,but less than that of LPS-pulsed DCs.DCs can engulf the Penicillium marneffei yeasts.When pulsed with Penicillium marneffei yeasts,DCs improved their expression of the co-stimulatory molecules and chemokine receptor CCR7、CXCR4,enhanced their capacity to process antigen.DCs play an important role in host defense against Penicillium marneffei infection.But the low level of the IL-12p70 production may lead to deficiency in the cell-mediated immunity against Penicillium marneffei.

Objective To discuss the semilateral supine position for retroperitoneoscopic adrenalectomy. Methods From Jan. 2006 to Dec. 2008, 36 patients (20 males and 16 females with mean age of 43 years) underwent retroperitoneoscopic adrenalectomy in 60° -70° semilateral supine position. There were adrenal cortex adenomas in 18 cases, pheochromocytoma in 6 cases, adrenal cysts in 3 cases, myelolipoma in 2 cases, gangliocytoma in 1 case, lymphangioma in 1 case, metastatic tumor in 1 case and corticohyporplasia in 4 cases. The mean diameter of the tumors was 2.6 cm( 0.5 - 7.7 cm ). The tumors were superior to the renal pole in 5 cases, anteromedial in 10 cases and superomedial in 17 cases. The three ports that were usually used in lateral position and were placed anteriorly to create retroperitoneal place: the first port was placed 2 -4 cm superior to the iliac crest along the anterior axillary line, the other two were placed just below the costal margin along the midaxillary line and at the same level along the midclavicular line, and dissected along the anterior surface of kidney to its superomedial aspect, so as to avoid the hampering of the kidney in the exposing of the diseased adrenal gland. Results The procedure was completed successfully in all of the cases with the operating time of 37 - 145 min ( mean 69 min) and intraoperative blood loss of 30 - 100 ml (mean 48 ml). Six cases had rupture of peritoneum, which were sutured and the procedure was continued to completion. The postoperative hospital stay was 3 -8 d (mean 5 d ). Thirty-five patients were available for follow-up of 3 - 28 months ( mean 14 months). The case of metastatic tumor died of the primary diseases in the 12th month postoperatively. No other complication was found. Conclusion With this alternative position and ports' location, the procedure of retroperitoneoscopic adrenalectomy could be easier and safer than the conventional position.

OBJECTIVETo investigate the feasibility of dynamic magnetic resonance diffusion tensor imaging (DTI) in rabbit models with implanted VX2 hepatic tumor grafts.

METHODSMRI and DTI images were obtained from 16 rabbit models with implanted VX2 hepatic tumor grafts (14, 18, 22, and 26 days after tumor implantation, respectively) and 4 normal rabbits. The average diffusion coefficient (ADC) and exponential ADC (eADC) were estimated and compared against pathological findings.

RESULTSThe ADC values increased after tumor implantation but then decreased in the rabbit models, whereas eADC exhibited a pattern of reverse changes. These changes significantly differed from those in the control group. Coagulation necrosis and fibrous hyperplasia showed obvious increase as found by pathological examination.

CONCLUSIONDynamic MR DTI quantitative analysis of rabbit models of implanted VX2 hepatic tumor can partially describe the growth behaviors of implanted liver cancer.

Animals ; Carcinoma, Hepatocellular ; pathology ; Diffusion Magnetic Resonance Imaging ; Female ; Image Enhancement ; methods ; Liver Neoplasms ; pathology ; Male ; Neoplasm Transplantation ; Rabbits ; Random Allocation